Sclerotherapy

Millions of people are bothered by spider and small varicose veins—those unsightly clusters of red, blue, or purple veins on the legs, face, hands, and other parts of the body. Dr. Rueckl treats these veins with sclerotherapy. In this rather simple procedure, veins are injected with a sclerosis solution, which causes them to collapse and fade from view. Over his 30 years in medicine, Dr. Rueckl has performed thousands of sclerotherapy procedures and has a treatment that is safe and effective. Previous sclerotherapy procedures were painful and often left permanent brown spotting behind from the vein destructions. Dr. Rueckl's advanced procedure does not have these side effects.

Dr. Rueckl is the only person at Lakes Dermatology who performs sclerotherapy. He has never delegated this responsibility to a Physician Assistant, Nurse, Medical Assistant, or anyone else. This fact is important to the integrity of his practice and to his patients' consistent care and his high patient return rate.

What is Sclerotherapy and what does it do?

Sclerotherapy is the injection and destruction of unnecessary veins using a very fine needle and specialized solution. The veins that are being destroyed are not veins that you need for blood flow—they are either spider veins or varicose veins.

Spider veins are small, thin veins that lie close to the surface of the skin. Although these super-fine veins are connected with the larger venous system, they are not an essential part of it. A number of factors contribute to the development of spider veins, including heredity, pregnancy and other events that cause hormonal shifts, weight gain, occupation or activities that require prolonged sitting or standing, and the use of certain medications. A photo of spider veins that can be treated with sclerotherapy are shown below.

Varicose veins differ from spider veins in a number of ways. Varicose veins are larger: usually more than a quarter-inch in diameter, darker in color, and tend to bulge. Varicose veins are also more likely to cause pain and be related to more serious vein disorders. For some patients, sclerotherapy can be used to treat varicose veins. However, surgical treatment is sometimes necessary for this condition and we can refer you to another practice during your consultation.

Most people get a good response to sclerotherapy, achieving a 90% improvement over a series of treatments. Treatments are usually done about 4-6 weeks apart. This gives the body time to absorb the veins which were injected at each session. Once a vein has been injected completely, that vein will not resurface.

Where is Sclerotherapy done?

Sclerotherapy treatments are most often done on the face and the legs, although any skin area may technically be treated. As people age sometimes they focus a great deal on improving the skin on their faces, but often ignore the aging of their hands. Sclerotherapy, in conjuction with liquid nitrogen or FotoFacials, is a great way to lose some of the signs of aging in the hands.

Sometimes people have a small amount of veins that can be treated in a few sessions, but most people need a minimum of four sessions to achieve their desired results. Individuals with a lot of veins may require more sessions. Your specific plan will be set during your initial consultation with Dr. Rueckl.

Veins that have been injected cannot resurface, but new spider and varicose veins can develop over time and you may need additional treatments over the years.

Why is Sclerotherapy different than lasers?

Some veins simply cannot be treated with lasers or Intense Pulsed Light (IPL). The best veins for laser and IPL treatments are those that are small, red, and clustered close together. Larger veins that are treated with lasers and IPL usually go into "spasm" and disappear for a bit, only to reappear at a later date. Additionally, very large veins and those that are bluish cannot be treated with lasers due to their size and color.

Because we have both lasers and IPL at Lakes Dermatology, Dr. Rueckl has the ability to combine these procedures along with his sclerotherapy treatments for patients that will benefit from multiple modalities.

What is a Sclerotherapy treatment like?

Dr. Rueckl and a Medical Assistant will discuss your treatment with you and have you sign a consent for the procedure. Prior to your sclerotherapy session, a topical anesthetic will be applied to reduce discomfort during the procedure. This anesthetic will be removed after approximately 20 minutes. Before Dr. Rueckl injects your veins, a medical assistant will pre-chill each injection site with a cold air chiller to reduce any discomfort you might experience. During the procedure, Dr. Rueckl will use an ultra-fine gauge needle and syringe filled with Polidocanol 1.5-2.0% in saline solution. Even though this solution was just recently FDA-approved, Dr. Rueckl has been using it for years and feels it is the safest and most effect sclerosing agent available. Each session for the legs takes about 45 minutes, plus the initial numbing time. A session for the face takes about 30 minutes total. You can return to normal activities that day, although excessive exercise and standing should be avoided for at least one day.

What kind of results can I expect from a Sclerotherapy treatment?

After the session, you may have small red spots where the needle was injected and small bumps like bee-stings. These should resolve within a day or so. Hydrocortisone cream or Benadryl can be taken to help. Although very rare, some patients can experience some slight brown spots post treatment. Your body should resolve of these over time, but these spots can be flashed with an IPL machine at our medical spa to hasten the recovery time if needed. The brown spotting will not be permanent; it's just your body's recovery process taking a bit longer.

You should have realistic expectations and remember that multiple sessions will be necessary. Each sclerotherapy session will result in fewer and fewer apparent veins. Though you will have some sites that are instantly better, the veins usually take a few weeks to totally absorb after each session. If there are particular sites that bother you, you should discuss these with Dr. Rueckl. He will also inject the sites he thinks need solution each time.

How much does Sclerotherapy cost?

Sclerotherapy is charged per visit. A treatment for the face is normally $100-$200 per session. A treatment for the legs is $450 per session. Other sites will need to be priced during a consultation.